About Pancreatic Cancer

Pancreatic cancer is a disease in which normal cells in the pancreas malfunction and begin to grow uncontrollably. These cancerous cells can eventually interfere with proper functioning of the pancreas and metastasize, or spread, to other parts of the body.

At UCLA, patients with pancreatic cancer are treated through the Pancreatic Cancer Program, a part of the UCLA Center for Pancreatic Diseases. The center combines the expertise of physicians from surgery, gastroenterology, radiology, medical oncology and pathology who are specialized in pancreatic diseases.

The Pancreas

The pancreas is a gland located deep in the abdomen between the stomach and the spine. The liver, intestine and other organs surround the pancreas. The pancreas is about 6 inches long and is shaped like a flat pear.

The widest part of the pancreas is the head, the middle section is the body and the thinnest part is the tail. The pancreas makes insulin and other hormones. These hormones enter the bloodstream and travel throughout the body. They help the body use or store the energy that comes from food. The pancreas also makes pancreatic juices. These juices contain enzymes that help digest food.

The pancreas releases the juices into a system of ducts leading to the common bile duct. The bile duct empties into the duodenum, the first section of the small intestine. The pancreas also produces enzymes, which are specialized proteins released into the small intestine that help the body digest and break down food, particularly fats. It is the cells lining these pancreatic ducts that most frequently turn cancerous. These are called ductal adenocarcinomas of the pancreas and represent the most common subtype of pancreatic cancer.

The endocrine component of the pancreas is made up of specialized cells clustered together in islands within the organ, called islets of Langerhans. These cells produce hormones, the most critical one being insulin, which is an important substance that helps control the amount of sugar in the blood.

Outlook and Prognosis

Pancreatic cancer is considered resectable if it can be surgically removed. These tumors may lie within the pancreas or extend beyond it, but there is no involvement of the critical arteries or veins in the area and there is no evidence of any spread to areas outside the pancreas. Approximately 10 to 15 percent of patients are diagnosed at this stage.

Pancreatic cancer is considered locally advanced if it is still confined to the area around the pancreas, but cannot be surgically removed because there is involvement of the critical arteries or veins or a direct extension of the tumor to surrounding organs. There is no evidence of spread to any distant areas of the body in locally advances pancreatic cancer. Approximately 35 to 40 percent of patients are diagnosed at this stage.

Pancreatic cancer is metastatic when the tumor has spread beyond the area of the pancreas and involves other organs, such as the liver or distant areas of the abdomen. Approximately 45 to 55 percent of patients are diagnosed at this stage.

Pancreatic cancer is considered recurrent if the cancer comes back after it was treated. It may be a locoregional recurrence (recurs within or close to the pancreas) or it may be a distant recurrence (recurs in another part of the body, such as in distant organs, bones or distant lymph nodes).